Periscope of Medical and General Science in their Relations to Dentistry. [Volume: 2, Issue: 12, July, 1861, pp. 681-694]

686

THE DENTAL COSMOS.

depression which often precede for weeks or months the onset of the
acute stage of tubercular hydrocephalus.
"Pure neuralgia, like the neuralgic headache of the adult, though less
common than this sick headache, if so I may term it, is yet sufficiently
frequent to need being borne in mind, when the question arises as to the
import of symptoms supposed to indicate cerebral disease. The headache
in these cases is usually frontal, and care is therefore the more necessary
since there is no doubt but that continued frontal headache is a very
frequent accompaniment of organic disease of the brain, and especially of
tubercle of that organ. The severity of the pain, the suddenness of its
onset, the completeness of its cessation, the fact that its recurrence for
days is attended by no progressive deterioration in the patient's condition,
all furnish a clue to its real nature. Moreover, its supervention after
exposure to malaria, and a certain ill-marked periodicity in its return, are
circumstances which will serve in many instances, no less than the absence
of other signs of disease of the brain, to guard against too hasty or too
positive an expression of an unfavorable prognosis. * * *
"We are all so familiar with the occurrence of convulsions during the
first dentition, that in infancy the risk is rather of the grave disease to
which they are possibly due being overlooked, than of the influence of
teething in their production being underrated. On the other hand, the
occasional share of the second dentition in exciting epileptic or other convulsive seizures is too little borne in mind, and a graver prognosis than the
event justifies is sometimes expressed in consequence.
" In a little work on Dentition, published some years ago by my friend
and former colleague, Dr. Ashburner, there are many cases related illustrative of this fact. Of these I will select the following:"'A boy, twelve years of age, was cutting the second or posterior permanent molars of the upper jaw before those of the lower, and the process
was accompanied by twitchings of various parts of the body. At last he
became affected with chorea. Being a very nervous lad, if any notice
were taken of him, he would quite involuntarily make the most extraordinary faces, and contort his body into various attitudes that appeared to
be most difficult and painful. This chorea continued for three months,
during which time a variety of medicines were swallowed. At last he fell
into an epileptic fit, struggling much, foaming at the mouth, and grinding
the teeth. I thrust my forefinger along the inside of his cheek, and found a
hard, cartilaginous space on each side, behind his first molar tooth. I
succeeded in gashing these parts. He uttered a scream and fell out of his
fit, becoming quite sensible, nor had he a recurrence of his chorea.'
" So sudden and complete a cessation of symptoms on the removal of
the mechanical irritation produced by the pressure of a tooth is decidedly
an unusual occurrence. In by far the greater number of instances, the
symptoms of disorder in the nervous system do not admit of being cut
short thus suddenly and decisively; they depend not simply on the local
irritation produced by one particular tooth, but, like the headaches which
I spoke of at the commencement of this lecture, they are the result of the
disturbance of the nervous system, to which the whole process of development has given rise, just as, in later life, the hysteria of the young woman
is connected with the imperfect accomplishment of the sexual function,
and is not removed by a single occurrence of menstruation.
"To this class of cases may be referred the history of a boy between
eleven and twelve years old, whom I saw some years ago. While, ap